Open AccessWhite‐Coat Effect Among Older Adults: Data From the Jackson Heart Study
Author(s) -
Tanner Rikki M.,
Shimbo Daichi,
Seals Samantha R.,
Reynolds Kristi,
Bowling C. Barrett,
Ogedegbe Gbenga,
Muntner Paul
Publication year - 2016
Publication title -
the journal of clinical hypertension
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.909
H-Index - 67
eISSN - 1751-7176
pISSN - 1524-6175
DOI - 10.1111/jch.12644
Subject(s) - medicine , white coat hypertension , blood pressure , confidence interval , ambulatory blood pressure , diastole , ambulatory , population , diabetes mellitus , kidney disease , cardiology , endocrinology , environmental health
Many adults with elevated clinic blood pressure ( BP ) have lower BP when measured outside the clinic. This phenomenon, the “white‐coat effect,” may be larger among older adults, a population more susceptible to the adverse effects of low BP . The authors analyzed data from 257 participants in the Jackson Heart Study with elevated clinic BP (systolic/diastolic BP [ SBP / DBP ] ≥140/90 mm Hg) who underwent ambulatory BP monitoring ( ABPM ). The white‐coat effect for SBP was larger for participants 60 years and older vs those younger than 60 years in the overall population (12.2 mm Hg, 95% confidence interval [CI], 9.2–15.1 mm Hg and 8.4 mm Hg, 95% CI , 5.7–11.1, respectively; P =.06) and among those without diabetes or chronic kidney disease (15.2 mm Hg, 95% CI , 10.1–20.2 and 8.6 mm Hg, 95% CI , 5.0–12.3, respectively; P =.04). After multivariable adjustment, clinic SBP ≥150 mm Hg vs <150 mm Hg was associated with a larger white‐coat effect. Studies are needed to investigate the role of ABPM in guiding the initiation and titration of antihypertensive treatment, especially among older adults.